Dissociative Disorders and Possibilities of Differential Diagnosticsof Epileptic and Psychogenic Non-epileptic Seizures

Overview

Differential diagnostics of epileptic and non-epileptic seizures is a problem based on distinguishingepileptic seizures with an organic etiology and non-epileptic seizures with a predominantpsychopathological etiopathogenesis. There is a growing evidence which supports a dissociativemechanism of non-epileptic seizures and dissociative psychopathology provides important findingsconcerning etiology and diagnostics.In these study 21 epileptic patients, 8 men and 13 women, mean age 33 were investigated by 5scales focused on dissociation (psychic and somatoform), posttraumatic stress disorder (PTSD),depression and child traumas (DES, SDQ-20, IES, BDI-II and TSC-40).Possibilities of differential diagnostics between non-epileptic and epileptic seizures are reversethan it is common in neurological practice, where diagnosis of non-epileptic seizure is the resultof excluding epilepsy after EEG monitoring. In this case diagnosis is based on confirmation ofpsychogenic non-epileptic seizures by a positive finding of dissociative symptoms. This examinationmakes possible earlier therapy and is an important complement of common neurologicaldiagnostics.

Key words:
epilepsy, psychogenic non-epileptic seizures, dissociative disorders, posttraumaticstress disorder.